乳腺黏液癌58例报告

Mucinous carcinoma of the breast:report of 58 cases

目的探讨乳腺黏液癌的临床特点、预后情况及治疗效果。方法对58例乳腺黏液癌患者(单纯型35例,混合型23例)进行回顾性分析,其中保乳手术15例,其余行改良根治术。分析临床特点及治疗与患者生存率的关系。结果女性乳腺黏液癌患者中位年龄47岁,绝经前患者占70.69%,病灶大小1～15cm。单纯型黏液癌无腋淋巴结转移,混合型转移率为65.22%。总5年生存率为89.66%(单纯型97.14%,混合型78.26%)。结论国内35～50岁女性良性肿瘤外观的乳房肿块活检需警惕为乳腺黏液癌。乳腺黏液癌预后较好,手术治疗中保乳的趋势增加。单纯型乳腺黏液癌通常无腋窝淋巴结转移,有希望取消腋窝淋巴结清扫。

Objective To explore the clinical features, prognosis and breast-conserving therapy of mucinous carcinoma of the breast （MCB）. Methods Fifty-eight cases of MCB were divided into two groups ： pure type （ n = 35 ） and mixed type （ n = 23）. Fifty patients were treated by breast-conserving surgery, the others were treated by modified radical mastectomy. The clinical features, treatment measures and follow-up results were analyzed. Results In female patients with median age of 47 years, 70.69% were premenopause. The tumor size ranged from 1 cm to 15 cm. None of the pure MCB patients demonstrated lymph node metastases, whereas 65.22% of mixed MCB patients did. The 5-year survival rate of MCB was 89.66% （pure type 97.14%, mixed type 78.26% ）. Conclusions MCB should be carefully examined in 35 - 50-year-old premenopausal women with tumor which seems benign on the surface and accurate diagnosis is made before lumpectomy. The prognosis of MCB is much better and the preferred method of treatment for MCB is conservative surgical therapy. The result shows pure MCB unlikely metastasize, axillary lymph node dissection may be unnecessary in the treatment of pure MCB.